Integrated endoscope irrigation

ABSTRACT

A distal tip of an endoscopic device and a cylindrical cap is disclosed. The distal tip comprises a pattern of alternating grooves and lands on its outer surface. The cylindrical cap is configured to fit tightly over the lands, thereby changing the grooves into closed channels through which liquid or gas can flow.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/661,202 filed on Oct. 23, 2019, which is a continuation of U.S.patent application Ser. No. 15/592,252, filed on May 11, 2017 and Issuedas U.S. patent Ser. No. 10/492,662 on Dec. 3, 2019, which is acontinuation-in-part of U.S. patent application Ser. No. 14/385,185,filed on Sep. 15, 2014, which is a National Phase of PCT/IL2013/050170having International filing date of Feb. 28, 2013, which claims thebenefit of priority of U.S. Provisional Patent Application No.61/616,097, filed on Mar. 27, 2012, the contents of which are allincorporated herein by reference in their entirety.

FIELD OF THE INVENTION

The invention is from the field of medical devices. More specifically,the invention is from the field of small diameter endoscopic devices.

BACKGROUND OF THE INVENTION

In various medical applications there are many advantages for usingsmall diameter endoscopes and laparoscopes (collectively calledendoscopes or endoscopic devices herein) having, for example, a maximumouter diameter of 3.2 mm. Most importantly small diameter endoscopes canbe introduced to desired locations within the body through smalldiameter natural orifices and lumens. Also in cases where introductionof the endoscope may be irritating, a small diameter endoscope maymitigate such phenomena. An example of a procedure in which smalldiameter endoscopes can be useful is transnasal endoscopy that in somecases may replace trans-oral endoscopy. Moreover, small diameterendoscopes may be introduced into body cavities by single incisionlaparoscopy, wherein the incision itself is of minimal dimensions.

By its nature, endoscopy entails incorporating many components adaptedto perform various functions within a single elongated instrument. Thisfact sometimes conflicts with the desire for minimum diameter and sizein general. Among these components are: imaging devices, e.g. videocameras; illumination devices, e.g. optical fibers or LEDS; articulationmeans; tissue collection devices or other surgical tools; irrigation,insufflation, and more.

One of the ways to accommodate as many components and functions aspossible is to decrease the size of each individual component, e.g.,using a smaller size camera or a smaller size fiber bundle. However,this is not always possible. There are limits to how much size reductioncan be achieved since each size reduction has its cost in terms ofperformance and assembly complexity.

It is therefore a purpose of the present invention to provide a methodof reducing the diameter of endoscope devices.

It is another purpose of the present invention to provide a method ofproviding an endoscopic device with more components without increasingthe cross section of the insertion tube.

Further purposes and advantages of this invention will appear as thedescription proceeds.

SUMMARY OF THE INVENTION

In a first aspect the invention is an endoscopic device that comprises ahandle section, an insertion tube connected to the handle section, adistal tip at the distal end of the insertion section, and a pluralityof tubes, wires, and cables that pass through the interior of theinsertion tube, and empty spaces between the plurality of tubes, wires,and cables. The empty spaces are utilized as a channel that enablesliquid or gas to flow from the handle section to the distal tip. Theendoscopic device is characterized in that the distal tip comprises ablock having a pattern of alternating grooves and lands on its outersurface and a cap comprising a hole at the center of the distal surfaceof the cylindrical cap. The hole is surrounded by an annular curvedportion. The cap fits tightly over the lands thereby forming channelsbetween the lands through which liquid or gas flowing through the emptyspaces can continue on its way to at least one nozzle that is formed bya gap between the front face of the block and the bottom surface of theannular curved portion of the cap.

Embodiments of the endoscopic device comprise at least one of:

-   -   (a) an articulation section located at the distal end of the        insertion tube proximally to the distal tip, the articulation        section is activated by cables or wires that pass through tubes        that extend the length of the interior of the insertion tube        from the handle section to the articulation section;    -   (b) an imaging device located in the distal tip, the imaging        device activated by power delivered to it and transmitting        images gathered by it via one or more cables, wires, or optical        fibers that pass through one or more tubes that extend the        length of the interior of the insertion tube from the handle        section to the distal tip;    -   (c) illumination devices located in the distal tip, the        illumination devices are activated by wires or optical fibers        that pass through one or more tubes that extend the length of        the interior of the insertion tube from the handle section to        the distal tip;    -   (d) one or more working channels that pass through the interior        of the insertion tube from the handle section to the distal tip;    -   (e) one or more other components each of which is located at a        location on the insertion tube or on the distal tip and is        associated with a tube, wires, or cable that passes through the        interior of the insertion tube from the handle section to the        location.

Embodiments of the endoscopic device comprise the handle sectioncomprises components of an articulation mechanism including articulationcylinders that are sealed by gaskets, which are adapted to enablemovement of the cables or wires that pass through the insertion tube tosteer the articulation section without leakage of liquid or gas betweenthe handle section and the insertion tube.

In embodiments of the endoscopic device the imaging device is a videocamera.

In embodiments of the endoscopic device the components located at alocation on the insertion tube or on the distal tip are selected from:lasers and radio frequency generators.

In a second aspect the invention is a method of reducing the diameter ofan endoscope device that comprises a handle section, an insertion tubeconnected to the handle section, a distal tip comprising a block and acap attached to the insertion tube, and a plurality of tubes includingat least one tube that serves as a liquid or gas channel, wires, andcables that pass through the interior of the insertion tube. The methodcomprises:

-   -   a) creating a pattern of alternating grooves and lands on the        outer surface of the block of the distal tip;    -   b) removing the at least one tube that serves as a liquid or gas        channel and allowing liquid or gas to flow from the handle        section to the distal tip through empty spaces between the        plurality of tubes, wires, and cables; and    -   c) fitting the cap over the block, wherein the cap comprises a        hole at the center of its distal surface surrounded by an        annular curved portion and the cap fits tightly over the lands        thereby forming channels between the lands through which the        liquid or gas flowing through the empty spaces can continue to        flow to at least one nozzle formed by a gap between the front        face of the block and the bottom surface of the annular curved        portion of the cap.

In the endoscopic device of the second aspect, the total cross sectionalareas of the empty spaces is as large as or larger than the crosssectional area of the at least one tube that has been removed, therebyallowing at least the same amount of fluid can be delivered to thedistal tip through the insertion tube after reducing its diameter as wasdelivered through the tube that was removed.

In embodiments of the method the liquid or gas that flows through theempty spaces between the plurality of tubes, wires, and cables that passthrough the interior of the insertion tube from the handle section ofthe endoscope to the at least one nozzle is used for at least one of thefollowing purposes: irrigation, insufflation, suction, cooling, heating,staining tissue, and therapy.

In a third aspect the invention is a distal tip comprising a blockhaving a pattern of alternating grooves and lands on its outer surfaceand a cap. Channels through which liquid or gas can flow are formed onthe outer surface of the distal tip by a fitting the cap tightly overthe lands on the outer surface of the block.

All the above and other characteristics and advantages of the inventionwill be further understood through the following illustrative andnon-limitative description of embodiments thereof, with reference to theappended drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 schematically shows some of the interior components of the handlesection of an endoscopic device;

FIG. 2 schematically shows an articulation section and a distal tip atthe distal end of a first embodiment of an insertion tube that can beconnected to the handle section shown in FIG. 1;

FIG. 3 schematically shows an enlarged view of the distal tip shown inFIG. 2;

FIG. 4 schematically shows the face of the distal tip shown in FIG. 2;

FIG. 5A schematically shows a transverse cross-section of a typicalprior art insertion tube comprising a water tube at a location betweenthe handle and the articulation section;

FIG. 5B schematically shows a transverse cross-section of a typicalinsertion tube not comprising a water tube at a location between thehandle and the articulation section;

FIG. 6 schematically shows the distal tip of the endoscopic device shownin FIG. 4 with part of the cap removed;

FIG. 7 schematically shows the distal end of a second embodiment of aninsertion tube that can be connected to the handle section shown in FIG.1;

FIG. 8 schematically shows a transverse cross sectional view through thedistal tip of the endoscopic device of FIG. 7; and

FIG. 9 schematically shows a longitudinal cross sectional view of thedistal end of the endoscopic device of FIG. 7.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION

Endoscopic devices are comprised of a handle section, an elongatedinsertion tube, and a distal tip at the end of the insertion section. Anarticulation section is often included at the distal end of theinsertion section just before the distal tip to allow the distal tip tobe deflected in order to change the angle of view of the imaging deviceand to aid in steering the insertion tube through bodily lumens to thelocation where the observations or procedure are to be carried out. Toprevent bodily fluids, tissue, or debris from entering the insertiontube, it and the articulation section are encased in a sheath ofpolymeric material.

The present invention is directed to endoscopic devices that typicallycomprise at least an imaging device, e.g. a video camera andaccompanying illumination means in the distal tip and optionally mayinclude an articulation section that is activated by cables or wiresthat pass through the interior of the insertion tube from anarticulation steering mechanism located in the handle section.Endoscopic devices frequently also comprise one or more workingchannels, through which surgical tools, e.g. forceps, snares, andtherapy devices, e.g. lasers or RF generators, can be introduced fromthe handle section to the space beyond the distal tip in order tocollect samples or carry out various procedures. In addition there arefrequently channels for other purposes, e.g. irrigation water or air toclean the camera lens, gas for insufflation, dye for staining tissue,liquid for cooling (or heating), and gas or liquid for therapy, e.g.delivery of drugs or medicine.

In present day endoscopic devices each of the working channels and thechannels for irrigation and insufflation are small tubes that runthrough the insertion tube from handle to distal tip. As an alternativeto having separate tubes for each component or function, endoscopes maycomprise a multi-lumen tube which contains separate lumens for eachcomponent. Also the optical fibers or electric wires for theillumination means and the power and signal wires to and from the camerapass through similar tubes. All of these individual tubes and thearticulation cables or wires are tightly packed into the interior of theinsertion tube.

FIG. 5A and FIG. 5B illustrate how the diameter of the insertion tube ofan endoscopic device can be reduced by removing the water channelaccording to the present invention.

FIG. 5A schematically shows a transverse cross-section of a typicalinsertion tube at a location between the handle and the articulationsection. In the figure can be seen how two illumination fibers 28,camera cable 44, two articulation cables 42, a tube for a workingchannel 50, and a tube for a water channel 52 are fit into the interiorof insertion section 14. The circumference of the insertion tube in FIG.5A is denoted by reference symbol 62.

FIG. 5B is a transverse cross sectional view of an insertion tube that,with the exception that there is no tube for a water channel, containsthe same tubes, illumination fibers, and cables having the samediameters as those in FIG. 5A. Water travels through the insertion tubein FIG. 5B through the empty spaces 54 (only one is marked in FIG. 5B)between the other components passing through the insertion section. Thecircumference of the insertion tube in FIG. 5B is denoted by referencesymbol 64.

As can be seen from FIGS. 5A and 5B, packing a plurality of tubes havinga circular cross-section into a larger cylindrical tube inevitable meansthat there will be empty spaces between the tubes that are not utilized.The current invention makes use of these spaces to allow fluid to flowfrom the handle of the endoscope to the distal tip. In this way it isnot necessary to have a separateirrigation/insufflation/cooling/dye/therapy channel and as a result theoverall diameter of the insertion tube can be reduced as demonstrated bythe comparison of circumference 64 in FIG. 5B with circumference 62(shown with a dashed line in FIG. 5B for comparison) of the insertiontube of FIG. 5A. It should also be noted that the cross sectional areaof each of the spaces 54 in FIG. 5B is less than the cross sectionalarea of the tube 52 (from FIG. 5A) that has been removed; however thetotal cross-section of all spaces 54 is equal to or larger than that oftube 54. This means that at least the same amount of fluid can bedelivered to the nozzle at the distal tip through the insertion tube inFIG. 5B as through that of FIG. 5A despite the smaller overall diameterof the insertion tube.

Alternatively to reducing the diameter of the insertion tube, theinvention allows the space formally occupied by the tube for a waterchannel to be utilized to pass additional components, e.g. an additionalworking channel, through the insertion tube.

FIG. 1 to FIG. 4 and FIG. 6 to FIG. 9 illustrate embodiments of anendoscope built according to the present invention.

FIG. 1 schematically shows the handle section of an embodiment of anendoscopic device with the cover partially removed to reveal some of theinterior components. Shown in FIG. 1 are the articulation handle 12 a,articulation drum 12 b, and articulation cylinders 12 c of articulationmechanism 12; insertion tube 14; illumination fibers and power andsignal wires 16; and gaskets 18.

When the cover of the handle section is in place it presses against thegaskets 18 forming an air and water tight compartment in the handle. Inparticular the two small O-rings seal the articulation cylinders andenable movement of the steering (articulation) cables or wires withoutleakage of fluid. An inlet port (not shown in the figure) allows waterfor irrigation or gas for insufflation to be introduced into thiscompartment. As will be described herein below, the water or gas flowsout of the compartment in the handle into and through the insertion tubeand exits the endoscope through a nozzle (or a set of nozzles) locatedon the distal tip.

Conventional endoscopic distal tips are made from a monolithiccylindrical block of metal or plastic comprising bores that pass throughthe block from its proximal end to its distal face to allow componentsof the insertion tube such as illumination fibers, camera cable, andworking channels to pass from one side of the distal tip to the othervia these bores. Additionally there can be cavities created on the frontsurface of the block to hold components such as a camera head or LEDs.For these distal tips the external surfaces of the block are smooth andshaped to minimize trauma as the endoscope is advanced to the site ofthe procedure.

In contrast to conventional distal tips, the distal tip of the presentinvention is comprised of two components: a) a block 22 comprising apattern of alternating grooves 32 and lands 34 that are created on itsouter surface; and b) a cap 24, which fits tightly over the lands 34 toprovide the distal tip with a smooth outer surface. The tops of lands 34are pressed against the inside wall of cap 24 forming hermetic sealsthat effectively convert grooves 32 into closed channels through whichwater or gas flowing through the insertion tube can continue on its wayto a nozzle on the distal end of the endoscope.

FIG. 2 schematically shows the distal end of an insertion tube 14 thatcan be connected at its proximal end to the handle section shown inFIG. 1. The sheath that covers the insertion tube has been removed toreveal articulation section 20 and the distal tip comprised of block 22and cap 24.

Also seen in FIG. 2 are tabs 46 and the tapered proximal end 36 of block22. Tabs 46 symbolically represent one way of connecting block 22 of thedistal tip to insertion tube 14. The tabs can be attached by any methodknown in the art, e.g. welding or gluing, to the distal end ofarticulation section 20 and to the tops of the proximal ends of lands 34on the outer surface of block 22. In other embodiments the block acts asor is attached directly to the distal link of the articulation section.The function of tapered proximal end 36 will be described herein below.

FIG. 3 schematically shows an enlarged view of the distal tip shown inFIG. 2 with the cap 24 completely removed from the block 22 and FIG. 4schematically shows cap 24 completely covering block 22. FIG. 6schematically shows the distal tip of the endoscopic device shown inFIG. 4 with part of the cap 24 cut away. In the embodiment shown inFIGS. 2, 3, 4, and 6 a cable for camera 26 and illumination fibersleading to light ring 58 pass through insertion tube 14.

FIG. 7 schematically shows the distal end of a second embodiment of aninsertion tube that can be connected to the handle section shown inFIG. 1. FIG. 8 and FIG. 9 respectively schematically show a transversecross sectional view and a longitudinal cross sectional view through thedistal tip of the endoscopic device of FIG. 7. In the embodiment shownin FIGS. 7, 8, and 9, in addition to the components shown in theprevious embodiment a working channel 50 passes through insertion tube14.

The method in which a nozzle (or nozzles) are created at the distal tipof the endoscopic device and the manner in which the fluid travels fromthe compartment in the handle to the nozzle is the same for bothembodiments.

As shown in FIG. 3, a circular portion at the center of the distalsurface of cylindrical cap 24 is removed leaving a hole 38 surrounded byan annular curved portion 40. As can also be seen in the same figure, apart 35 of the distal end of each land 34 is removed, With the insertionsection 14, including the articulation section, completely covered withthe sheath 56 and the cap 24 in place over the block 22 as shown inFIGS. 4, 6, 7, and 9 the inside of the endoscope is hermeticallyisolated from the outside with the exception of a small gap 48 betweenthe front face of the block 22 and the bottom of curved surface 40around the circumference of hole 38 in cap 24. The shape of curvedsurface 40 causes the gap 48 to function as a circular nozzle 30.

Water or gas introduced into the compartment in the handle enters theinsertion tube 14 and flows through the empty spaces 54 between thetubes and cables that pass through insertion tube 14 and articulationsection 20. On reaching block 22, the fluid travelling down theinsertion tube the tapered proximal end 36 and is forced to the sidesand through the grooves. The water or gas flows through grooves 32 andout of the distal end through circular nozzle 30. The components of thedistal tip are configured such that water or gas exiting throughcircular nozzle 30 is sprayed over the illumination fibers 28 andobjective lens of camera 26 keeping them clean. It is noted thattapering the proximal ends of block 22 is one of several ways that couldbe employed to allow the fluid to flow from the handle at the proximalend to a nozzle or nozzles at the distal end of the endoscopic device.

FIG. 6 shows the distal tip of the endoscopic device shown in FIG. 4with part of the cap 24 removed to reveal the lands 34 and grooves 32 onthe outside surface of block 22 and the gap 48 between the front face ofblock 22 and the bottom of curved surface 40 of cap 24 that functions ascircular nozzle 30.

FIG. 7 schematically shows the distal end of an embodiment of endoscopicdevice. Seen in this figure is sheath 56 covering the insertion tube anddistal tip 14. A camera 26, light ring 58, and working channel 50 areseen on the front face of the distal tip. Gap 48 is seen between thebottom of the curved portion 40 of the cap 24 that covers the block 22of the distal tip.

FIG. 8 schematically shows a transverse cross sectional view through thedistal tip of the endoscopic device of FIG. 7. Seen in the figure areworking channel 50, a cavity 26 for a camera head, and light ring 58.Also seen are the lands 34 and grooves 32 on the surface of the block22, the cap 24 that fits tightly over the lands and overlaps the sheath56, and articulation cables 42.

FIG. 9 schematically shows a longitudinal cross sectional view of theendoscopic device of FIG. 7. Seen in this figure are articulationsection 20 and articulation cables 42. The distal end of eacharticulation cable 42 is bent to form a sort of tab 46 that is fixedlyattached to the proximal end of block 22, for example by soldering orwelding, thereby attaching the distal tip 22 to the articulation section20. The proximal part 36 of block 22 is cut at an angle to allow waterflowing through the insertion tube between the tubes and cables enclosedby sheath 56 to enter the grooves 32 between lands 34 and to flowthrough the grooves 32 to the curved annular end 40 of cap 24 thatcovers the grooves 32 and lands 34. When water reaches curved annularend 40 it flows through gap 48 and is sprayed over the front face ofblock 22 exiting through hole 38. Also seen are channels for the cameracable 44 and illumination fibers 28, working channel 50, and a cavity 60into which a camera head can be inserted.

The embodiments described herein are configured to comprise a circularnozzle, i.e. a nozzle that creates a spray emitted in all (360 degrees)directions. In other embodiments the grooves 32, lands 34 and hole 38 inthe cap 24 can be configured to direct the liquid or gas to form one ormore nozzles that will emit a spray having any desired angular spread.

It is noted that only very basic embodiments of an endoscopic devicehave been described herein in order to illustrate the principle of theinvention. In addition to a working channel, camera and illuminationmeans, the endoscope may comprise additional working channels, and othercomponents located on the distal tip, e.g. ultrasound transducers. Allof these require their own tube, cable, or wire that must be integratedinto the interior of the insertion tube. In these embodiments,eliminating the need for a separate irrigation and/or insufflationchannel by utilizing the spaces between the other tubes for the passageof water or gas as taught by the present invention will play animportant role in reducing the overall diameter of the insertion tube.

Although embodiments of the invention have been described by way ofillustration, it will be understood that the invention may be carriedout with many variations, modifications, and adaptations, withoutexceeding the scope of the claims.

1. A distal tip configured to be attached to a distal end of aninsertion tube of an endoscopic device, the distal tip comprising: apattern of alternating grooves and lands on an outer cylindrical surfacethereof, such that upon tightly fitting a cylindrical cap over thelands, the grooves become closed channels, the cylindrical cap comprisesa hole at a distal surface thereof, the hole surrounded by a portion ofthe cap that covers all of the distal surface of the distal tip notexposed by the hole; wherein a gap is formed between the distal surfaceof the distal tip and an interior surface of the portion of thecylindrical cap when the cylindrical cap is in placed over the distaltip, and wherein the closed channels on the outer cylindrical surface ofthe distal tip and the portion of the cylindrical cap are configuredsuch that, after the distal tip is attached to the distal end of theinsertion tube, fluids introduced into a proximal end of the insertiontube flow out of the insertion tube through the gap and out of the holewhich is thereby configured to functions as a nozzle.
 2. The distal tipaccording to claim 1, wherein the hole at the distal surface of thecylindrical cap is circular.
 3. The distal tip according to claim 1,wherein the hole at the distal surface of the cylindrical cap issubstantially in the center of said surface.
 4. The distal tip accordingto claim 1, further comprising an imaging device.
 5. The distal tipaccording to claim 1, further comprising one or more illuminationdevices.
 6. The distal tip according to claim 1, wherein the fluid isused for irrigation, insufflation, suction, cooling, heating, stainingtissue, and/or therapy.
 7. An endoscopic device comprising the distaltip of claim
 1. 8. The endoscopic device according to claim 7, furthercomprising a handle connected to the proximal end of the insertion tube.9. The endoscopic device according to claim 8, wherein the fluids areintroduced into the proximal end of the insertion tube via said handle.10. The endoscopic device according to claim 7, further comprising anarticulation section at the distal end of the insertion tube.
 11. Amethod of providing fluid to a region of interest in a body of asubject, the method comprising inserting the endoscopic device accordingto claim 7, into the region of interest.
 12. The method according toclaim 11, wherein providing the fluid irrigation, induces insufflation,suction, cooling, heating, staining, or therapy in the region ofinterest.